Autologous hematopoietic stem cell transplantation for relapsed/refractory systemic anaplastic large cell lymphoma. A retrospective analysis of the lymphoma working party (LWP) of the EBMT
Autologous hematopoietic stem cell transplantation for relapsed/refractory systemic anaplastic large cell lymphoma. A retrospective analysis of the lymphoma working party (LWP) of the EBMT
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DOI：
10.1038/s41409-019-0734-7
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发表时间：
2020-04-01
影响因子：
4.8
通讯作者：
Dreger, P.
中科院分区：
文献类型：
--
作者：
Domingo-Domenech, E.;Boumendil, A.;Dreger, P.
系统性间变性大细胞淋巴瘤（sALCL）是一种表达CD 30抗原的罕见组织学实体，约占外周T细胞淋巴瘤的11%。我们分析了接受自体干细胞移植（auto-HCT）治疗的复发性/难治性sALCL患者的结局。我们纳入了65例成人患者（42例男性;中位年龄44岁）; 24例患者患有ALK阴性sALCL。51名患者在移植时患有化学敏感性疾病。10例患者（15%）在auto-HCT前接受维布妥昔单抗（BV）治疗（中位给药次数：5）。存活患者的中位随访时间为35个月（3-71）。三年累计非复发死亡率和复发率分别为1.7%和34%。3年无进展生存率和总生存率分别为64%和73%。在单变量分析中未发现任何预后因素。接受BV治疗的患者与其他患者之间的任何结局均无显著差异。这是迄今为止分析auto-HCT在复发性/难治性sALCL患者中的作用的最大规模分析，显示在该高风险人群中具有良好的PFS和OS。需要进一步阐明在手术前给予BV作为挽救策略的潜在影响。
Systemic anaplastic large cell lymphoma (sALCL) is a rare histological entity expressing the CD30 antigen that comprises around 11% of peripheral T-cell lymphoma. We analysed the outcome of patients with relapsed/refractory sALCL treated with autologous stem cell transplantation (auto-HCT). We included 65 adult patients (42 males; median age, 44 years); 24 patients had an ALK-ve sALCL. Fifty-one patients had chemosensitive disease at the time of transplant. Ten patients (15%) were treated with brentuximab vedotin (BV) before auto-HCT (median number of doses: 5). The median follow-up for surviving patients was 35 months (3-71). Three-year cumulative incidence of nonrelapse mortality and of relapse were 1.7% and 34%, respectively. Three-year progression-free survival and overall survival were 64% and 73%, respectively. No prognostic factors for any of the outcomes analysed were found in univariate analysis. There were no significant differences in any of the outcomes between patients who had received BV and the remainder. This is the largest analysis presented so far analysing the role of auto-HCT in patients with relapsed/refractory sALCL, showing a promising PFS and OS in this high-risk population. The potential impact of the administration of BV as salvage strategy before the procedure needs to be further elucidated.